The MNA will be continuously reviewing all incoming messages and social media posts in order to address members’ questions and concerns in a timely manner. This document will be prominently posted at www.massnurses.org/Covid-19, and will be dated accordingly. Questions? Call 781-821-4625, or email email@example.com. Please note: The newest questions will be highlighted in yellow.
Q: I am hearing a lot about the decontamination and reuse of PPE. What are the facts? Is decontamination safe?
A: The lack of reliable information on these practices, as well as the potential safety risks of these decontamination procedures pose risks to the health and safety of health care workers, as well as the general public at large, require that these practices be halted. Read the MNA’s full position statement here.
Q: What about hazard pay?
A: With the lack of PPE at most hospitals, as well as delays in both testing and setting up COVID-specific units/floors, we believe nurses should now assume that everyone in the hospital is COVID-positive — patients, nurses, healthcare professionals (HCPS), and all other hospital staff. In this scenario, a request for hazard pay is moot, as everyone is caring for COVID patients. Instead, the priority should be on employers acquiring and distributing appropriate PPE to all staff. Additionally, the MNA’s position is that all COVID-19 patients should be cared for on all-COVID units or floors, which will go a long way in controlling spread once instituted. In this latter scenario, we again believe the focus should be on acquiring and distributing proper PPE, but unionized RNs and HCPs may want to consider pushing for incentive pay. This would help to mobilize a team of RNs and HCPs that is dedicated to caring for COVID patients exclusively. We also encourage MNA members to review their contracts to see if relevant language already exists.
Q: What are the best rules/guidelines around use and reuse of N95s?
A: The MNA believes that due to this unique virus that has already spread throughout our communities, all RNs working in a hospital and all visiting nurses should be wearing surgical grade N95 masks with a face shield. If we are to stop the rapid spread of the virus this step needs to be taken now. It will do no one any good if in three weeks we have saved N95 masks, but 40% of the RNs are ill and cannot care for patients.
Q: My hospital is not following the MNA's recommendations for proper N95 use. What can I do?
A: Notify your immediate manager at the hospital and, if not corrected, contact your elected local MNA bargaining unit representative who will then contact your associate director of labor at the MNA. The MNA will be both tracking these concerns collectively, as well as advocating locally to have these situations addressed. Hospitals must be held accountable for providing for your safety and the safety of your patients.
Q: I am confused about how Workers’ Compensation and Unemployment work during the COVID-19 emergency. Can you please clarify things for me?
Q: How do we deal with issues around cleanliness of hospitals? I am not seeing an increase in overall cleaning (surfaces, door handles, etc.).
A: MNA recognizes that the increased cleaning of high-touch surface areas is a critical issue. It should be brought to the attention of the administration via the CNO, but also via direct communication with the head of your hospital’s Environmental Services (housekeeping) department. This issue is an excellent example of the great importance of having your elected MNA representatives participate in daily huddles, meetings, conference calls, etc. with your CNOs and other directors. We recommend this as a best practice at every hospital during this crisis. We also recommend that MNA members call upon their specific unit managers and directors to conduct unit-based huddles to discuss exactly these types of issues once during every shift. If administration at your hospital has not yet implemented these types of communications opportunities, the MNA will support you in doing so. Again, contact your elected MNA leadership ho can the coordinate with your associate director of labor at the MNA.
Q: With cancellation of elected surgeries, can operating room nurses be forced to work in other areas?
A: We must look at this in the context of being a once-in-a-lifetime, unprecedented public health emergency. We should always observe contractual language, the “Nurse Practice Act,” and common sense as they all require that RNs be floated with an orientation to other units and not be assigned tasks for which they are not qualified and trained. That said, this is an all hands-on deck crisis. We have been very critical of the few hospitals in the state that have proposed to furlough OR RNs, given the state mandated (at the MNA’s urging) cessation of all non-urgent medical procedures. We have been pointing to the critical need of the hospitals to staff up and not down during the crisis.
Q: If I become sick or presumed-positive and must be out of work, will I have to use my earned/PTO time? Management says I must.
A: We urge each employer to pay its RNs for time spent in quarantine or out ill due to the COVID-19 virus since it is a work-acquired disease. Alternatively, if an RN receives worker’s compensation then the employer should pay the regular wage during the five (5) day waiting period and pay the difference
between the worker’s compensation amount and the RN’s regular weekly wages.
It is the MNA’s position that no healthcare worker should have to pay out of their accrued time banks for quarantine or illness related to the COVID-19 emergency.
Contact your committee members or MNA associate director for help in more complicated situations.
Q: If I get tested for the virus and am positive, and I quarantine for two weeks, must I get retested before returning to work?
A: Currently, once tested positive and quarantined two negative test results need to be recorded before returning to work is allowed.
Q: What can the hospital mandate us to do under the state of emergency and future external disaster code/declarations? If I leave, is this fire-able?
A: The state law banning mandatory overtime for RNs in hospitals explicitly contains a provision that suspends the law in times of declared government emergencies, as is the case now. That said, your
individual hospital’s collective bargaining agreement still is in effect. Refer to its overtime provisions as it may or may not have an exception for declared states of emergency. One provision that is in many MNA contracts (but again, refresh yourself on yours) is the provision that states, “A nurse who is too fatigued or ill to perform her duties may notify the Patient Care Director or Administrative Coordinator of Nursing that she/he is too fatigued or ill to perform her/his duties." Or words to this effect.
It is important to remember that even during a state or federal emergency your contract is in effect and is enforceable.
Q: If pregnant or immunocompromised, do I have the right to decline taking a possible COVID-19 patient?
A: Yes. The MNA has taken the position that any nurse who falls into these categories should have the absolute right to opt out of caring for COVID-19 patients. We strongly recommend that your primary care clinician provide you with written documentation outlining your risk and stating that you should not be taking care of COVID-positive patients. If you are placed in that situation, contact a member of your elected MNA committee.
Q: If a patient is receiving nebulizer treatments, they must be in a negative pressure room, correct? What if I get to work and this isn’t the case?
A: Yes, the patient should be in a negative pressure room. When a negative pressure room is not available, anytime a nurse is entering the room with a COVID-19 patient or rule-out, the nurse must be wearing proper PPE. For a nebulizer treatment or any aerosol generating procedure, this must include an N95 mask or higher protection if available.
Q: How safe are negative pressure rooms? What about the ones that are about to be “created” (including those proposed at Carney as it transitions to an all-COVID hospital)?
A: Negative pressure rooms are safe as long as they are maintained by the facility and kept clean. Currently in construction there are building codes involving both national and state health care requirements as well as CDC recommendations for negative pressure rooms to meet environmental and engineering control criteria when being built. These rooms will be periodically inspected to meet building inspection codes during construction. This will ensure the safety for both patients and staff.
- Any time one is entering a room with a COVID-19 patient or a rule out, one must be wearing PPE. For a nebulizer treatment or any aerosol generating procedure, this must include an N95 mask.
- Remember that a negative pressure room does not provide any added protection to the people inside the room, but rather the purpose is to prevent disease spread beyond the room. Therefore, if you are in the room, you should adhere to what is outlined in number one (above).
- The MNA supports the efforts of hospitals to quickly engineer additional negative pressure rooms during this crisis. To whatever extent the rushed engineering may be imperfect, it is better than the alternative. Given the potential growth of COVID-19 cases, Massachusetts hospitals will be out of negative pressure rooms very quickly.
More on negative pressure rooms at https://www.hfmmagazine.com/articles/2671-planning-and- maintaining-hospital-air-isolation-rooms.
Q: What about hazard/premium pay for employees who care for COVID-19 patients?
A: On-call for volunteers or other incentive mechanisms can be considered to maximize available work force who are able to care for COVID patients.
Q: If you are a healthcare provider that is immunosuppressed, do you need to provide documentation to wear a mask? What if you have your OWN supply of masks?
A: If you are immunosuppressed the MNA recommends that you contact your healthcare provider and ask for documentation from the provider that states you have clearance to work. If your physician states that you should not work with presumptive or COVID-positive patients, then you should be assigned to a lower risk patient population. If your physician states that you can in fact work with a lower-risk population you should still wear PPE, preferably N95 due to the increased risk.
A known supply of masks may be used if they are manufactured and designed for healthcare (N95 or higher).
A: I have a high-risk diabetic elder at home, and I’m worried about bringing COVID-19 back to her. What if I need to be out of work to care for family if they contract this from me bringing it home to them?
Q: For exactly this reason the MNA is advocating that hospitals and the state government provide housing during the crisis for hospital staff who do not want to, and should not expected to, return home between their shifts and expose vulnerable family members. That said, until this is available, the MNA advocates that hospital staff ask for accommodations to opt out of COVID-19 cases or presumptive cases if any of the following are true for you or the family member(s) you live with and/or care for:
- Has a preexisting cardio-pulmonary condition
- Are pregnant
- Must return to a home off shift that they share with someone who is in a vulnerable population (the list above). This problem would be alleviated for many if housing were provided
Q: My department does not provide bedside/direct patient care to patients. In lieu of “social distancing” why aren’t more departments that are not on the frontline being asked to work remotely for the safety of more staff and patients?
A: Yes. The MNA’s position is that on the one hand this is all hands-on deck for providing direct patient care, and staff will inevitably be asked to take on emergency responsibilities (consistent with certifications and competencies, and/or be provided appropriate training). That said, the MNA believes that staff without direct patient-care responsibilities who can work remotely should be allowed to work remotely.
Q: How and where can people donate masks and supplies? Can I volunteer?
A: We are continuously working to identify and vet reputable donation and distribution sources, as well as volunteer programs that can support frontline healthcare providers across the commonwealth. We will be regularly adding to the list below:
The Greater Boston Labor Council "Volunteer Brigade"
In the wake of the COVID-19 public health crisis, the GBLC is working with the Walsh Administration to coordinate volunteer efforts in the City of Boston and is seeking union members to help local communities in a variety of ways. If you can volunteer, please fill out this short form and the GBLC will be in contact when needs arise.